NPI HDX Services Readiness Strategy

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NPI HDX Services Readiness Strategy

• Kathy Ducharme Sheryl McClelland

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HDX Services NPI Implementation Strategy

• NPI Overview
• HDX Eligibility Service
• HDX Electronic Claims Service
• HDX Electronic Remittance Service

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NPI Overview

• Final Rule mandated 5/23/2007
• Standard unique identifier for Health Care
  Providers
• Type 1 Individual
• Type 2 Organizational
• Providers must apply for their NPIs
• NPPES assigns NPIs www.nppes.cms.hhs.gov/NPPES/W
  elcome.do
• 10 digit number last digit is a self check
  digit (ISO Luhn)

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HDX Eligibility Service

• Goals
• Implementation Strategy
• Timeline

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HDX Eligibility Service - Goals

• Utilize the Dual Use Strategy proposed by WEDI
• Insulate Providers from varying Payer timelines
• Ability to react to Payer changes quickly
• Provide a solution that requires only one set of
  changes for the Providers

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HDX Eligibility Service Implementation Strategy

• Providers send both Legacy identifiers and NPI on
  eligibility requests
• Option 1 NPI as primary, Legacy as secondary
• Option 2 Legacy as primary, NPI as secondary
• HDX preference is Option 1
• HDX will maintain a transparent table of all
  payers indicating their NPI processing
  requirements
• HDX will map the identifiers according to the
  payers requirements
• Transaction will be successful as long as the
  Providers eligibility request contains the data
  needed for the Payer.

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HDX Eligibility Service - Timeline

• October 1, 2006 - Communication to all our
  Provider Integration Partners
• December 1, 2006 - Internal Testing with Provider
  Integration Partners
• January 2007 - HDX Eligibility Service changes
  implemented in Production
• January 2007 - Providers begin sending NPI

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HDX Electronic Claims Service

• Goals
• Implementation Strategy
• Timeline

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HDX Electronic Claims Service - Goals

• Utilize the Dual Use Strategy proposed by WEDI
• Enable Providers to Migrate Individually
• Provide a solution that requires only one set of
  changes for the Providers
• Enable Providers to easily submit their NPIs

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HDX Electronic Claims Service Implementation
Strategy

• ECS Customer Option
• Supports NPI at both the facility and doctor
  level
• Recommend confirmation of third-party, payer, and
  remittance software readiness
• ECS Payer Option
• INVISION/UNITY customers MUST submit NPIs to
  Siemens
• ERSCONTACT.MED_at_SIEMENS.COM
• NPI is used to route transactions and reports
• Recommend confirmation of payer and remittance
  software readiness

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HDX Electronic Claims Service - Timeline

• NPI ready NOW
• October 31, 2006 Customer Memo Z061031C
• ECS Payer Option
• INVISION/Unity Providers must submit NPI
• Contact us now via ERSCONTACT.MED_at_SIEMENS.COM
• NPI ready - once NPI submission process is
  complete
• January 2007 can submit NPI via web page

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HDX Electronic Remittance Service

• Goals
• Implementation Strategy
• Timeline

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HDX Electronic Remittance Service - Goals

• Utilize the Dual Use Strategy proposed by WEDI
• Enable Providers to Migrate Individually
• Provide a solution that requires only one set of
  changes for the Providers
• Enable Providers to easily submit their Payee
  level NPIs
• Early Adopter Testing

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HDX Electronic Remittance Service Implementation
Strategy

• Supports WEDI advocated Dual-Use transition
  strategy
• Customers MUST submit Payer level NPIs to
  Siemens
• Siemens must load NPI into Enrollment Database
• Update OML for Invision/Unity customers
• NPI will be used to route transactions and
  reports to appropriate destination
• Submit your NPPES NPI Enumeration documents

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HDX Electronic Remittance Service - Timeline

• October 31, 2006 Customer Memo Z061031C
• November 2006
• Contact Siemens to initiate NPI submission
  process
• Contact us now via ERSCONTACT.MED_at_SIEMENS.COM
• December 2006 Claims Remit 3.8 Customer Memo
• December 2006 begin Early Adopter testing
• January 2007 - submit NPI via web page (if not
  already submitted)
• Jan/Feb 2007 Changes implemented in Production

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For Your HDX NPI Information

• www.hdx.com
• Read about HDX NPI strategy or WEDI press
  releases
• Read additional information on related links
  sidebar
• Upcoming Customer Memos
• WEDI Call to Arms listed on website
• Contact us
• HDXSERVICESNPI.MED_at_SIEMENS.COM

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18
Question and Answer Session
The Power of HDX
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This presentation is designed to give conclusive
examples of how we deliver the best practice
integration.

The Power of HDX
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The Power of HDX